What is Ectropion?

Ectropion is the medical term used to describe an outward turning or malposition of the lower eyelid and lashes. The eyelid margin is everted or turned out. The result of the eyelid being turned out is typically excessive tearing because the eyelid is not properly able to remove the tears from the eye to the tear duct because of its malposition.

There are typically three common types of ectropion. The most common type is an involutional ectropion which occurs because of a relaxation of the tissues of the eyelid as a result of the aging process.

Cicatricial ectropion is caused by a shortage of skin on the eyelid usually due to scar formation either from surgery, radiation, infections or inflammation. The eyelid is typically pulled away from the eye and may assume a red or infected appearance.

Paralytic ectropion is caused by paralysis of the seventh nerve which controls the muscles of facial expression. Paralysis of this muscle can be present at birth or more commonly a result of surgery, infection, inflammation or injury. Patients with a paralytic ectropion usually are not able to close their eyelid and are at risk for exposure keratopathy (drying of the cornea) and epiphora (tearing).

Ectropions should be surgically corrected before the cornea (front part of the eye) has irreversible exposure, scarring and/or becomes infected. The goal of surgery is to tighten the eyelid and its attachments to its normal anatomic position. Cicatrical ectropions may involve the use of a skin graft in order to correct the position of the eyelid. Paralytic ectropions may involve the placement of a gold weight in the upper eyelid to allow the patient to close their eyes.